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According to a study by the AARP, 30% of primary-care physicians already have some kind of pay-for-performance incentive written into their plan contracts, and 28% of group practices include performance benchmarks. Since 2007, Massachusetts has required all its citizens to have health insurance, about 20% of which involves some kind of global coverage - handling all of a patient's health-care needs for the duration of the policy. In July, the state announced plans to go further, eliminating fee-for-service entirely within five years and mandating global care statewide. Similar plans are ramping up in Minnesota...
Casale was charged with implementing the new plan. The first thing he and his team did was take 20 general steps all surgeons follow throughout a bypass episode and try to sharpen them in a way that would remove as much chance and variability as possible, going so far as to spell out the specific drugs and dosages doctors would use. The result was an expanded 40-step list that some surgeons balked at initially, deriding what they called "cookbook medicine." Once doctors began following the expanded checklist, however, they grew to like it. After the first 200 operations...
...fact that the state is home to so many pricey academic medical centers. That may be true, but you can bet that Massachusetts' remaining one of the priciest health-care providers in the U.S. was not among the selling points when advocates of universal coverage were stumping for the plan. Similarly, global care may correct the problem - or harbor bear traps...
...meet your targets and your paycheck will dwindle. And some docs may chafe at being hitched to a team. One sweetener Dartmouth's Fisher recommends is forgiving some medical-school debts - an idea Obama endorsed at an Oct. 5 photo op with doctors, though in his plan, the break would be limited to those who agree to work in underserved or rural markets...
...European Organization for Nuclear Research (CERN) was arrested Oct. 8 after French officials discovered encoded e-mails between him and members of an al-Qaeda cell based in North Africa. Adlčne Hicheur, who worked at CERN's Large Hadron Collider near Geneva, allegedly offered to help the group plan attacks in France. Initial news reports focused on Hicheur's work at the high-energy research lab, prompting speculation that al-Qaeda might be attempting to create nuclear or radioactive weapons. But a spokesman for CERN said the lab has been closed since last September and that it doesn...